title: What is the impact of Helicobacter pylori density on the success of eradication therapy: a clinico-histopathological study.
abstract: OBJECTIVE
  To investigate the presence of any possible association between H. pylori density in the stomach and the efficacy of triple (lansoprazole 30 mg b.i.d., clarithromycin 500 mg b.i.d. and amoxicillin 1g b.i.d. for 14 days) and bismuth-containing quadruple (colloidal bismuth subcitrate 300 mg q.i.d., lansoprazole 30 mg b.i.d., tetracycline 500 mg q.i.d. and metronidazole 500 mg t.i.d. for 14 days) eradication therapies.
  
  
  METHODS
  Eighty-five cases with H. pylori infection (proved by rapid urease test and histology) were studied. In each case, the density of H. pylori colonization was graded according to the updated Sydney classification. H. pylori eradication was determined via the (14)C-Urea breath test performed 4 weeks after the end of therapy.
  
  
  RESULTS
  The eradication rate of H. pylori was 50% (30 out of 60) in the triple therapy and 92% (23 of 25) in the quadruple therapy group. In the triple therapy group, the eradication rate of H. pylori decreased as the initial density of H. pylori increased (density of H. pylori: 1, 58.3%; 2, 54.5%; 3, 52.4%; 4, 38.5%; 5, 33.3%). In two cases with eradication failure after quadruple therapy, the grades of bacterial density were 1 and 3.
  
  
  CONCLUSIONS
  H. pylori density, as assessed by histological grading, may predict the usefulness of triple therapy. The higher the H. pylori density, the less effective triple therapy will be at successful eradication of H. pylori. Quadruple therapy does not seem to be negatively affected by bacterial density.
authors.affiliation: Department of Gastroenterology, Ankara Oncology Education and Research Hospital, Ankara, Turkey. Electronic address: koralonal@yahoo.com.
authors.forename: Ibrahim Koral
authors.initials: IK
authors.lastname: Onal
authors.forename: Hale
authors.initials: H
authors.lastname: Gokcan
authors.forename: Emine
authors.initials: E
authors.lastname: Benzer
authors.forename: Gulay
authors.initials: G
authors.lastname: Bilir
authors.forename: Erkin
authors.initials: E
authors.lastname: Oztas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001944:Breath Tests; D016022:Case-Control Studies; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000382:microbiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D064747:Lansoprazole / Q000627:therapeutic use; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000382:microbiology; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D013270:Stomach / Q000382:microbiology*; D013752:Tetracycline / Q000627:therapeutic use; D016896:Treatment Outcome; D014508:Urea; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D009942:Organometallic Compounds; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D008795:Metronidazole; D000658:Amoxicillin; D014508:Urea; D013752:Tetracycline; D017291:Clarithromycin; C002791:bismuth tripotassium dicitrate